Provider Demographics
NPI:1467789008
Name:MAINEGENERAL REHABILITATION AND NURSING CARE
Entity Type:Organization
Organization Name:MAINEGENERAL REHABILITATION AND NURSING CARE
Other - Org Name:MGH EARLY LEARNING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NONA
Authorized Official - Middle Name:O
Authorized Official - Last Name:BOYINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-626-2611
Mailing Address - Street 1:6 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 GLENRIDGE DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6606
Practice Address - Country:US
Practice Address - Phone:207-626-2626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAINEGENERAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME165230200Medicaid